Every year, National Rural Health Day is a chance to recognize and celebrate the dedicated efforts of rural health advocates and partners working to improve rural life. On November 20, 2025, The Rural Impact celebrated with something special, a live, story-driven event that lifted the voices behind The Rural Effect.

Over the past two years, over a dozen Community-Based Organizations across Massachusetts led bold, creative, community-rooted work that rippled across 143 rural towns, resulting in expanded access, stronger trust, and lasting local change.

Rural Impact Host and Creator, as well as Rural Effect producer and storyteller, Michelle Rathman, brought together rural leaders who expanded access, belonging, and opportunity, along with staff from community benefit organizations reaching the most remote corners of the state, and leaders from the New England Rural Health Association advancing rural health equity, to share their stories in a special livestream event.

As we kick off a new year with a keen focus on tracking rural health transformation and other policies that impact over 60 million people, we invite you to listen to this special episode.

Every conversation offered something valuable, insight, hope, inspiration, and a reminder that rural communities hold extraordinary potential, and indeed are the #powerofrural.

Special thanks to Kirby Lecy, Jennifer Kimball, Ezekiel Baskin, Sarah Garvin, and Brea Corsaro.

In part one of the last episode of 2025, 'Uncertain Times for Community Health Centers,' Michelle invites Feygele Jacobs, DrPH, MS, MPH to The Rural Impact. Dr. Jacobs is the Director of the Geiger Gibson Program in Community Health and Professor of Health Policy and Management at the Milken Institute School of Public Health, George Washington University. Previously, she was President and CEO of the RCHN Community Health Foundation, a non-profit dedicated exclusively to supporting and benefiting health centers and their communities and patients. Her diverse background includes positions in Medicaid managed care, public health care systems, and teaching hospitals.

Summary

Michelle Rathman speaks with Dr. Jacobs about the critical role of community health centers in the American healthcare system, especially in light of recent legislative changes such as HR1. They discuss the challenges these centers face, including funding cuts, Medicaid work requirements, and the impact of immigration policies on access to care. The conversation highlights the importance of these centers in serving vulnerable populations and the potential consequences of policy changes on healthcare access and quality.

In part two of this episode, Michelle talks with National Association of Community Health Centers Chief Policy Officer, Joe Dunn. Joe is a two-time graduate of the George Washington University, Joe has spent the last twenty years in Washington, DC, on Capitol Hill and in a variety of government relations roles. Joe joined NACHC in January 2021 as Senior Vice President for Public Policy and Research from Cigna. Prior to this, he was in senior positions in three congressional offices, including Connecticut Senator Chris Murphy.

Michelle and Joe discuss the critical role of community health centers in rural America, highlighting their contributions over the past 60 years, the challenges they face, and the importance of advocacy. They delve into the Rural Health Transformation Fund, workforce shortages, funding instability, and the need for innovative solutions to overcome geographic isolation. The discussion emphasizes the significance of community voices in shaping health policy and ensuring the sustainability of these vital health services.

In this episode, 'A Conversation About the Intersections of Policy and Philanthropy,' Cara V. James, PhD, President and CEO of Grantmakers in Health (GIH), joins Michelle to explore key topics like rural health funding challenges and the critical conversations shaping health policy.

Before joining GIH in 2020, James served as Director of the Office of Minority Health at the Centers for Medicare & Medicaid Services (CMS) in the US Department of Health and Human Services, where she provided leadership, vision, and direction to advance health equity. Under her guidance, CMS developed its first CMS Equity Plan to Improve Quality in Medicare, its first Rural Health Strategy, created an ongoing initiative to help individuals understand their coverage and connect to care, increased the collection and reporting of demographic data, and developed numerous tools and resources to advance health equity.

In this conversation, Michelle and Cara talk candidly about how philanthropy can address health disparities, especially in rural communities, and the impact of government policies on nonprofit funding, emphasizing community engagement and leadership in advancing health equity.

The conversation highlights the need for a collaborative approach to improve healthcare access and population health, stressing the importance of systemic change and the freedom to give, encouraging listeners to consider how they can support these efforts.

In this episode, "A Conversation About the State of America's Family Farms," Hannah Tremblay and Caitlin Arnold Stephano, both from Farm Aid, discuss issues impacting America's small and family farms.

Hannah Tremblay is Policy and Advocacy Manager, where they manage Farm Aid's advocacy program and engage a broad coalition in support of policies that strengthen family farmers and family farm agriculture. Hannah has worked as an agricultural technical specialist and a farmer throughout the Northeast and Mid-Atlantic since 2014.

Caitlin Arnold Stephano joined the organization in the fall of 2021 as the Hotline Program Manager. Caitlin grew up riding the tractor at her Grandfather's cherry and apple farm in Eastern Washington state, and has been working in agriculture, farmer organizing, and advocacy since 2006. Caitlin holds a Master's in Sustainable Food Systems with a focus on farmer mental health

In this conversation, Michelle speaks with Hannah and Caitlin about Farm Aid's mission to support family farmers, the implications of the ongoing stalled farm bill, the myriad of challenges farmers face, including economic policies that harm small farms, and the importance of community advocacy and supporting local farmers by purchasing their goods. Also covered in this conversation is the increasing demand for the Farm Aid hotline services, the impact of climate change and immigration policy on farming, and the need for improved disaster relief and support systems for farmers.

The conversation emphasizes the critical role of local and federal policies in sustaining small farms and the importance of community engagement in supporting farmers.

In this episode, "Finding Common Ground in Community Engagement," Michelle welcomes Meredith Dean, the National Director of the Rural Urban Bridge Initiative's Community Works program, to discuss how rural communities are finding common ground and bringing people together, regardless of political differences, to address local needs.

Meredith brings 40 years of experience in community organizing, Democratic politics, non-profit management, and teaching in both formal and informal settings, from adults to higher education to kindergarten. She and her husband settled 39 years ago in a ruby red Virginia county nestled in the beautiful Blue Ridge section of the Appalachian Mountains, where they raised their son, 13 cats, four dogs, and a horse.

In this conversation, Michelle Rathman and Meredith Dean discuss the importance of community engagement in rural areas, particularly through the Community Works initiative. They explore the impact of national policies on local communities, the need for trust and collaboration across political divides, and practical steps for individuals to get involved in community improvement efforts. The discussion emphasizes the significance of addressing local needs, fostering relationships, and creating sustainable solutions for rural challenges.

The episode emphasizes how sustainable engagement requires ongoing effort and commitment, and how cross-political collaboration can lead to practical and effective solutions.

In this episode, "Ready. Set. No. The State of Medicaid Work Reporting Requirements Readiness," Michelle welcomes Research Professors Tricia Brooks and Leonardo Cuello, as well as State Health Policy Analyst Hannah Green, all joining us from Georgetown University McCourt School of Public Policy Center for Children and Families, to discuss their report published on September 4, 2025 titled "Are States Ready to Implement HR 1 and Medicaid Work Reporting Requirements?"

In this conversation, Michelle, Hannah, Tricia, and Leo discuss the implications of the HR1 Medicaid work reporting requirements, focusing on state readiness, the impact on coverage for lawfully present immigrants, including the dispelling of misinformation on the matter, and the challenges that counties and rural communities, households, and economies can expect to face and manage in the months and years to come.

The discussion highlights the importance of states meeting quality performance indicators, how funding and staffing cuts can further undermine the achievement of even minimum standards, and explores strategies for community engagement with multiple parties, as well as the urgency of advocacy around the rising uninsured rate among children and the financial strain on rural hospitals.

The conversation closes with a discussion about data collection and transparency, noting that researchers rely on timely and accurate CMS data to inform and educate policy decisions.

This episode was made possible by our partner, the National Association of Rural Health Clinics, and they invite you to rendezvous with them in Reno. Starting October 20, the two-and-a-half-day NARHC Fall Institute offers a unique in-person agenda, along with three pre-conference webinars the week before. It's a rare opportunity to deeply engage with the pressing issues facing Rural Health Clinics today. Plus, with unmatched networking and a throwback 90s Bash, you'll leave energized and reconnected. Registration closes on the evening of October 19, so don't wait! Visit narhc.org to register.

In this episode, "A Conversation About What Undermines Local Government and Public Service," Michelle welcomes Brooks Williams to discuss how anger and rage are impacting local governments. Brooks is a city manager whose two decades span public and private leadership. He is known for turning strategy into results, such as stronger finances, healthier cultures, and clear metrics that track real performance. He serves the QTF Regional Program, a performance-excellence initiative that helps organizations apply the Baldrige Excellence Framework, continuous improvement, and disciplined measurement to achieve lasting outcomes. A doctoral candidate in Public Administration, with an MPA from Liberty University, Brooks also writes to move leaders from noise to substance. His books, Performative Outrage: How Manufactured Fury Undermines Local Government and Public Service and Rising to Serve: Reimagining Public Administration for a New Era, challenge institutions to prove value through measurable excellence, accountability, and public trust.

Michelle invited Brooks to this episode to explore how anger and rage is impacting small governments. Together, they discuss the challenges and opportunities in public service, particularly in the context of performance outrage and the erosion of public trust. Brooks emphasizes the importance of transparency, civic engagement, and the role of social media in shaping public discourse. He advocates for a shift towards more constructive dialogue and the need for public servants to act as culture shapers within their communities. Brooks also highlights the necessity of civic literacy and education to empower citizens and improve local governance.

This episode was made possible by our partner, The National Association of Rural Health Clinics, and they invite you to rendezvous with them in Reno!!!

Starting October 20th, the two-and-a-half-day NARHC Fall Institute offers a unique in-person agenda, along with three pre-conference webinars the week before. It's a rare opportunity to deeply engage with the pressing issues facing Rural Health Clinics today. Plus, with unmatched networking and a throwback 90s Bash, you'll leave energized and reconnected. Registration closes the evening of October 19th, so don't wait! Head to narhc.org to register.

In this episode, "HRSA's Dwindling Rural Health Commitments," we kick off with a conversation between Michelle and Alexa McKinley Abel, Director of Government Affairs at the National Rural Health Association. They delve into recent developments from the House Appropriations Committee related to the FY2026 Labor-HHS appropriations bill, which proposes significant investments and increases in rural health funding. The two also dissect a new provision in the Rural Hospital Provider Assistance Program, which, if passed, offers financial support to at-risk hospitals. They wrap up with a discussion that underscores the need for increased funding and the impact of community stories in underlining the importance of these programs.

Next, Michelle welcomes Carole Johnson, former Administrator of the Health Resources and Services Administration, and current Senior Fellow at the Century Foundation. Michelle speaks with Carole about the current state of rural health, focusing on the challenges posed by workforce reductions, funding cuts, and the need for community engagement. They discuss the impact of these issues on healthcare services in rural areas and the importance of advocacy in securing the necessary resources in the long term. Carole emphasizes the need for immediate action to address funding gaps and significant cuts to HRSA's workforce, responsible for administering rural health programs, some of which have been eliminated or paused.

In the second half of this in-depth episode, Michelle speaks with Toniann Richard, CEO of HCC Network, about the critical issues facing rural health organizations, particularly in relation to Medicaid and the Rural Health Transformation Fund. They discuss the challenges of navigating policy changes, the importance of grassroots advocacy at the state level, and the need for community engagement in health initiatives. The conversation also addresses vaccine hesitancy in rural Missouri and the role of public health in these areas in building confidence and capacity, highlighting the importance of providing reliable information and support to communities.

This episode was made possible by our partner, The National Association of Rural Health Clinics and they invite you to rendezvous with them in Reno!!!

Starting October 20th, the two-and-a-half-day NARHC Fall Institute offers a unique in-person agenda, along with three pre-conference webinars the week before. It's a rare opportunity to deeply engage with the pressing issues facing Rural Health Clinics today. Plus, with unmatched networking and a throwback 90s Bash, you'll leave energized and reconnected. Registration closes the evening of October 19th, so don't wait! Head to narhc.org to register.